Health officials in West Sussex are considering proposals to fly patients to Germany to beat long NHS waiting lists.

The idea was drawn up by Crawley Primary Care Group, which wanted to send batches of people needing hip and knee replacement operations to the Continent.

Patients would be treated at Lutherhaus Hospital, near Essen, in the first airlift of its kind.

But there was confusion today over whether the CPCG would be allowed to send patients abroad for treatment.

A Department of Health spokesman later said: "The situation is that the primary care group did come up with a proposal for this but it has not been approved by West Sussex Health Authority.

"The primary care group does not have the authority to send patients abroad itself. There is plenty of private sector capacity locally for them to use and that is what they are intending to do."

But West Sussex Health Authority confirmed that it was looking at a range of options for treating patients, including care abroad.

It is understood that Crawley Primary Care Group is in advanced talks with GerMedic, a private health company representing 120 hospitals in Germany.

The cost of each hip operation would be £6,600, compared with just under £4,000 in Britain.

The cost would include return flights for the patient and a companion, taxis between the airport and hospital, operating fees and medical costs.

Patients would remain in hospital for 21 days, which is longer than NHS patients stay in this country, and the companion is likely to be accommodated in a hotel or hospital guesthouse for a week.

Brian Howard, chief executive of Crawley PCG, was unavailable for comment today, but he was reported as saying: "Provided we secure funding the first 50 patients could be on their way by the end of September or October."

Mr Howard said he could not see why the Department of Health should object.

A West Sussex Health Authority spokeswoman admitted today it had problems offering patients short waiting times. Treatment overseas was one of a series of short-term options being explored.

Chief executive Cathy Morris said: "We will only consider transferring patients abroad if we can't treat them in this country using NHS and other available services and we have no reason at this stage to suppose we can't."

Waiting times in West Sussex are among the highest in the country. The health authority blames the average age of the population, with ten per cent aged over 75.

A spokeswoman said: "Because West Sussex is one of the healthiest places in the country and the population lives longer, this means there is great demand for treatment."